Peaceful Death Still Misunderstood

Ethical issues relating to the peaceful death are still misunderstood, according to LawPundit's review of new evidence regarding brain activity during a "vegetative state."

In Terri Schiavo Judges and Justices Should Step Down, blogger and attorney Andis Kaulins cites new research reported in Science magazine proving "that some brain-injured patients who - according to medical experts - are allegedly in a vegetative state because they are allegedly completely unresponsive and unaware of their surroundings, are in fact aware of their surroundings."

LawPundit quotes researchers to suggest that the new evidence may show that patients such as "'Terri Schiavo, the Florida woman in a persistent vegetative state whose family dispute over whether to discontinue her care ignited a national debate over the right-to-die issue," were in fact conscious.

LawPundit writes: "But the true fact is, no one really knows, because no one is God and knows that much about the human brain at the present time. Schiavo's brain was in good enough shape to keep ALL her bodily functions running when fed, which is a complex undertaking. But some medical and legal gurus decided to play God with Schiavo's life, for motives which they will have to answer to their Maker. When the legal system and medical profession play God, unforgivable errors are inevitable."

So far, so good.

However, the conclusion that LawPundit draws is that is was legally (as well as ethically) wrong to hasten the death of Terri Schiavo and that doing so constituted "killing."

I agree with LawPundit that: "For all anyone knows, Terri Schiavo's brain may have followed her slow death by starvation and dehydration clear down to the last minute." But that goes to the manner of death and not to its fact.

No one can judge whether someone's death is justified or not; not I, not some other legal analyst or pundit. As Kaulins notes, "no one is God."

LawPundit argues that this death "was an inexcusable and unforgivable action carried out by modern bloodletting, once a standard medical practice everywhere, an incredibly stupid and ignorant practice of which, e.g., America's first President, George Washington, was a fatal victim." That's going a bit far, in my opinion.

Many bioethicists have tried to draw a distinction between active and passive euthansia, the former supposedly being unacceptable and the latter unacceptable.

To which another perspective, that of Buddhism, suggests that what matters is that a person make the transition from this life with a peaceful mind, with clarity, and in a place of compassion.

I was very impressed some years ago seeing the same argument put together both in "The Tibetan Way of Living and Dying" by Sogyal Rinpoche, and by Daniel Callahan, a founder of the Hastings Center who does not purport to be adopting a Buddhist perspective but merely a rational one based on essential bioethical values.

Focusing on the importance that the dying have patient clarity of mind and be supported by compassion, Callahan urges bioethics to recognize the value of "the peaceful death," as opposed to "wild death" that is all too common.

This in turn suggests that the distinction between "active" and "passive" euthanasia is misplaced; in fact, actively helping someone make the transition in a mindful, prayerful, and reverent environment may be more meaninful (ultimately) than allowing someone's body to exit through slow starvation.

Yet bioethics has been slow to relinquish its tenacious hold on the distinction between 'active killing' (impermissible) and 'passive killing' (grudgingly permissible).

It may only be our sense of culpability, and our failure to understand the borderland between living and dying, that makes us accept a tenuous philosophical proposition instead of focusing on emotional and spiritual realities. (Both emotional and spiritual realities, or at least the former, one woudl argue, are verifiable in the heart, though perhaps not on the pages of Science magazine.)

LawPundit appears unconcerned with this level of the debate, and merely focuses on the legal decision as unsupported by evidence regarding brain activity: "We at LawPundit continue to be astounded by the blatant lack of critical thought and the pervasive historical ignorance manifested by mainstream scientists and professionals in many fields of human endeavor, especially among the leading authorities in such fields, whose prevailing view of their profession appears to be that the truth exists, and that THEY have found it, today, in our era."

I agree. But the problem may be more one of emotional and spiritual ignorance, than medical ignorance.

I use the term "spiritual ignorance" consciously, aware that some may misread into it claims of spiritual superiority. Once again, no one can judge or claim to know God's mind, but one can turn within -- through self-inquiry, contemplation, and meditation -- to decide these delicate ethical choices from a place of balance and centeredness (assuming that is feasible, and one is not suffering from one religious delusion or another).

I made the argument for the compassionate, peaceful death, a la Callahan, in Beyond Complementary Medicine: Legal and Ethical Perspectives on Health Care and Human Evolution, and renew in Healing at the Borderland of Medicine and Religion a call to harken for consensus around the silent, still space that bring the subjectivity of spirituality around toward places of shared recognition.

To do otherwise and simply condemn and call for judges to leave the bench is simply to pull into the same duality that condemns many to the untranquil, tormented death. That is the world that is often denoted the 'pairs of opposites.'

It was Einstein who noted that problems cannot be solved at the same level at which they are created. Only awareness -- consciousness -- can lift the mind out of the muck of useful distinctions, and help us find common ground between consensus spiritual perceptions, and consensus notions in ethics such as Callahan's notion that the peaceful death is more valued than its chaotic cousin.